Approximately 30 percent of psychiatric inpatients have a depressive syndrome with a delusion. Most clinicians prefer not to use electroconvulsive therapy as an initial treatment for these patients. Consequently, this leaves the clinician the choice of using an antipsychotic alone, an antidepressant alone, or an antipsychotic plus an antidepressant to treat these patients. There have been no controlled studies, with the exception of our current investigation, evaluating the relative and absolute efficacy of these treatments by random assignment of patients to one of these three treatment regimens. The main objective of this supplement is to measure plasma levels of perphenazine to determine the relationship between treatment response, side effects, and blood levels. It is hypothesized that plasma levels of perphenazine will correlate better with response and side effects than the oral dose.